创伤性膈疝的诊断和治疗

目的 总结创伤性膈疝的诊治经验。方法 回顾性分析自１９７２年１月至１９９８年８月４家医院收治的８５例创伤性膈疝，其发生原因为穿透性损伤４３例，闭合性损伤４２例，９５．３％的病人合并其它脏器损伤。手术治疗采用剖胸术１１例，剖腹术７２例，剖腹后剖胸术２例。结果 术前确诊５８例，全组治愈７８例，死亡７例，病死率８．２％。

Diagnesis and treatment of traumatic diaphragmatic hernia

Objective Experiences in the diagnosis and treatment of traumatic diaphragmatic hernia were reported.Methods The clinical data of 85 patients treated for traumatic diaphragmatic hernia from January 1972 to August 1998were analyzed retrospectively. Among the 85 casesl 43 resulted from penetrating injuries and 42 due to closed injuries.95. 3 % (81/85) of the patients had other associated injuries. Thoractomy was used in 11 cases and laparotomy in 72. 2cases required subsequent thoractomy. Results The diagnosis was established preoperatively in 58 cases(68. 2 % ). 78patients were cured and 7 died(8.2 % ). Conclusion Once the diagnosis of traumatic diaphragmatic hemia is established, surgical operation should be performed as early as possible. Laparotomy can be considered as the first operative approach to be chosen for most patients of acute traumatic diaphragmatic hernia. Chest X - ray plays an important role inmaking a diagnosis. Early diagnosis, timely surgical repairs of diaphragmatic rupture, prompt and correct treatment of associated injuries are the key to improve the cure rate and reduce mortality.